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Adults With Severe Mental Illness 5 Times More Likely to Die Prematurely

Everyone with a severe mental illness should receive an annual physical health check, as experts said that over 26,000 adults with severe mental illness die prematurely from preventable illness each year.

Adults with severe mental illness are almost five times more likely to die before the age of 75 from preventable illness in England, and the mortality gap is growing, said the Royal College of Psychiatrists.

A spokesperson for the College explained that severe mental illness (SMI) was a subset of mental illness and the term only applied to those with a diagnosable mental, behavioural, or emotional disorder that causes severe functional impairment that "substantially interferes with, or limits, one or more major life activities". This included, for example, psychosis, post-traumatic stress disorder (PTSD), schizophrenia, and bipolar disorder.

There were over half a million (535,204) adults with a diagnosed severe mental illness in England as of March 2023.

New data from the Office for Health Improvement & Disparities (OHID) showed 120,273 adults in England with severe mental illness died before the age of 75 between 2018 and 2020. 

The College estimated that 2 of 3 (80,182) people with severe mental illness died prematurely from preventable illness, for example heart and cancer diseases, between 2018 and 2020 – an average of 26,727 people every year. These deaths could have been prevented with "earlier detection and treatment or lifestyle changes", the College stressed. 

Andy Bell, chief executive of Centre for Mental Health, host organisation of Equally Well UK, said the thought it was "unacceptable" that people with a mental illness didn’t receive adequate help for their physical health, "so many lives were being lost too soon".

Mental Illness Makes Physical Health Self-Care Difficult

Cancer is the leading cause of premature death amongst those with a severe mental illness, with those with severe mental illness over twice (2.3 times) as likely to die prematurely.

However, the College pointed out that adults with severe mental illness were also on average:

  • 6.6 times more likely to die prematurely from respiratory disease
  • 6.5 times more likely to die prematurely from liver disease
  • 4.1 times more likely to die prematurely from cardiovascular disease

Dr Adrian James, president of the Royal College of Psychiatrists, said: "I know from the people I see that having a severe mental illness can make looking after your physical health much more difficult."

While adults with severe mental illness were more likely to engage in unhealthy behaviours, such as smoking and drinking alcohol excessively, they were also less likely to access screening and treatment for a range of reasons, including stigma associated with having a mental illness, highlighted the spokesperson.

Mortality Gap Widening

The mortality gap between those living with severe mental illness and the rest of the population was widening, worried the College. Over 3 years (from 2015 to 2017), adults with a severe mental illness were 4.6 times more likely to die before the age of 75 than those without a severe mental illness, it said. Of concern, was that in the following 3 years (from 2018 to 2020), this had increased to 4.9 times.

"This shocking inequality in health is getting worse and it's time for concerted action to close the gap," Mr Bell pointed out.

The College called on the Government to close this mortality gap, and to provide full annual health checks to everyone with a severe mental illness – comprising blood pressure, blood glucose and blood lipids tests, plus BMI, alcohol status, and smoking assessments. 

The NHS Long Term Plan committed to only 390,000 adults with severe mental illness receiving a full annual physical health check by 2023-24, noted the College. The latest figures from NHS England showed only just over half (58%) of those with a severe mental illness had received a full physical health check in 2022-23.

"Having a severe mental illness shouldn’t be an early death sentence," remarked Dr James.

He urged everyone who knew someone with severe mental illness to "look out for them", and ensure they received professional support for both their physical and mental health problems.